晶状体玻璃体切除联合人工晶状体植入三联或多联手术

Combined triple/multi-surgery of vitrectomy-lensectomy and posterior chamber intraocular lens implantation

目的 探讨晶状体玻璃体切除联合人工晶状体植入三联或多联手术的可行性和安全性。方法 对 32例 ( 32只眼 )患者进行上述联合手术治疗 ,其中 2 9例眼外伤 ,包括外伤引起白内障或晶状体脱位及玻璃体积血 ,部分患者伴球内异物、虹膜损害或根部断离 ,1例老年性白内障术中晶状体核和 2例术后人工晶状体落入玻璃体腔内。结果 随访 1～ 14个月 (平均 5 6个月 ) ,术后最佳矫正视力≥ 0 5者 15例 ( 46 9% ) ,0 1～ 0 4者 11例 ( 34 4% ) ,<0 1者 6例 ( 18 8% )。术后平均散光2 10DC。黄斑水肿 14例 ,占 43 8%。结论 三联或多联手术方式是安全可行的 ,影响术后视力恢复的主要因素是散光和黄斑水肿。选择适应证及掌握娴熟的操作技巧是手术成功的关键。

Objective To study the feasibility and safety of the combined triple/multisurgery of vitrectomylensectomy and posterior chamber intraocular lens implantation Methods Triple/multisurgery was performed on 32 eyes of 32 cases, including 29 cases of serious eye injuries of traumatic cataract, lens luxation, vitreous hemorrhage (some cases with intraocular foreign body, iris damage or iridodialysis), 1 case with lens nucleus dislocated into the vitreous cavity during the senile cataract surgery and 2 cases with intraocular lens luxated into the vitreous cavity postoperatively Results After follow up for 1～14 months (mean 56 months), 15 cases had the best corrected visual acuity (BCVA)≥05 (469%), 11 cases had BCVA of 01～04 (344%), and 6 cases had BCVA <01 (188%) There was an average of 210 DC of astigmatism after surgery Macular edema was found in 14 cases (438%) Conclusions The results suggest that the triple/multisurgery be safe and feasible The major causes affecting the postoperative BCVA are astigmatism and macular edema Proper selection of indication and skillful manipulation are the key points of the combined surgery